Project Grant H79TI086863

CLEAR PATHS TO ENDING THE EPIDEMIC - THE BROWARD HOUSE (BH) CLEAR PATHS TO ENDING THE HIV EPIDEMIC PROGRAM WILL PROVIDE LOW-BARRIER THERAPEUTIC SUPPORT SERVICES TO SUPPORT RECOVERY FROM SUBSTANCE USE DISORDERS (SUDS) AND CO-OCCURRING MENTAL HEALTH CHALLENGES (CODS) TO ANY MEMBER OF A RACIAL/ETHNIC MEDICALLY UNDERSERVED MINORITY GROUP LIVING WITH OR AT RISK OF HIV IN BROWARD COUNTY. WITH 35 YEARS OF EXPERIENCE WORKING WITH THE POPULATION AND AS THE ONLY HIV-SPECIFIC SUBSTANCE USE TREATMENT PROGRAM IN THE STATE, THE AGENCY HAS UNIQUE INSIGHT INTO THE INTERSECTIONALITY OF HIV, SUBSTANCE USE, AND MENTAL HEALTH CHALLENGES AND THE COMPLEX BARRIERS TO ACCESSING CARE AND ACHIEVING AND MAINTAINING HEALTH AND STABILITY. AGENCY EXPERIENCE HAS SHOWN THAT TRADITIONAL TREATMENT PROVIDERS CANNOT PROVIDE THE SAME SAFE AND AFFIRMING ENVIRONMENT NEEDED FOR PERSONS LIVING WITH HIV (PLWH) TO FEEL COMFORTABLE, BE VULNERABLE, OPEN UP, AND DISCUSS THE THINGS NECESSARY TO RECOVER TRULY. FOR THIS SAME REASON, TREATMENT IS PROVIDED WITH ON-SITE HOUSING AND INTENSIVE WRAP-AROUND SUPPORTS, AND FOR A MORE EXTENDED PERIOD, AVERAGING FIVE MONTHS, TO ENSURE CLIENTS HAVE A MOMENT TO STABILIZE THEIR HEALTH, OVERCOME ADDICTION, BUILD HEALTHY SKILLS, AND ACCESS RESOURCES TO SUPPORT LONG-TERM SUCCESS AFTER THEY LEAVE. STILL, ACCORDING TO PARTICIPANT FEEDBACK, TRANSITIONING FROM THE HIGHLY STRUCTURED ENVIRONMENT IN TREATMENT TO MORE INDEPENDENT LIVING IS ESPECIALLY DIFFICULT. THEREFORE, THE AGENCY PLANS TO UTILIZE CLEAR PATHS AS A BRIDGING PROGRAM, HELPING CLIENTS MAINTAIN HEALTH, VIRAL SUPPRESSION, AND RECOVERY SUCCESS. THE GOALS OF THE CLEAR PATHS INITIATIVE ALIGN WITH THE HEALTHY PEOPLE 2030 AHS, MHMD, SDOH, AND IID CATEGORIES, THE PRESIDENT'S NATIONAL HIV/AIDS STRATEGY 2022-2025 (NHAS), AND THE ENDING THE HIV EPIDEMIC (EHE) STRATEGIC PLAN TO REDUCE THE SPREAD OF HIV. THEY INCLUDE PROVIDING ON-SITE HIV/STI/HEPATITIS TESTING, RISK ASSESSMENT, AND EDUCATION TO 100 CLIENTS ANNUALLY WITH EXPEDIENT LINKAGES TO MEDICAL CARE AND RYAN WHITE CASE MANAGEMENT SERVICES FOR INDIVIDUALS TESTING POSITIVE FOR HIV AND PREP/PEP FOR INDIVIDUALS TESTING NEGATIVE WITH INCREASED RISK FACTORS. MOREOVER, THE AGENCY WILL PROVIDE INTEGRATED CO-OCCURRING BEHAVIORAL HEALTH TREATMENT, HOUSING NAVIGATION, AND CASE MANAGEMENT SERVICES TO THESE CLIENTS, TOTALING 500 OVER THE 5-YEAR PROJECT PERIOD. IN ADDITION, THE AGENCY WILL RECRUIT 10% OF CLEAR PATHS CLIENTS EACH YEAR AS PEER ADVOCATES AND INTERVIEW THEM TO DEVELOP ROLE MODEL STORIES WHICH THEY WILL DISTRIBUTE AMONGST THEIR SOCIAL NETWORKS TO FACILITATE HOPE AND RECRUIT NEW PARTICIPANTS INTO THE PROGRAM, LEVERAGING THE VALUE OF LIVED EXPERIENCE AND UNIVERSALITY TO REACH SYSTEMS-FATIGUED INDIVIDUALS INACCESSIBLE THROUGH TRADITIONAL CHANNELS. IN THIS SAME SPIRIT, CARE COUNSELORS WILL DELIVER SERVICES WITH THE LEAST POSSIBLE BARRIERS, HOLDING SESSIONS IN THEIR OFFICE, OVER THE PHONE, VIRTUALLY, AND OUT IN THE FIELD, MEETING PARTICIPANTS ANYWHERE THEY FEEL COMFORTABLE-AT RESIDENCES, SHELTERS, CAMPSITES, PARKS, COFFEE SHOPS, AND OTHER AGENCIES. THIS LESS TRADITIONAL, MORE HOLISTIC CARE MODEL, WITH MULTIPLE TOUCHPOINTS AND A COMBINATION OF PERSONAL AND SYSTEMS-LEVEL INTERVENTIONS, IS THE BEST WAY TO BUILD TRUST AND ENSURE INDIVIDUALS MAKE LASTING IMPROVEMENTS. SINCE 1988, BH HAS SERVED INDIVIDUALS IN BROWARD COUNTY WHO ARE VULNERABLE TO AND LIVING WITH HIV. SERVICES INCLUDE ASSISTED LIVING AND TRANSITIONAL HOUSING, MEDICAL AND NONMEDICAL CASE MANAGEMENT, MENTAL AND BEHAVIORAL HEALTH COUNSELING, SUBSTANCE USE TREATMENT, PEER SUPPORT, ADVOCACY, A COMMUNITY FOOD PANTRY, HIV/STI PREVENTION, OUTREACH, AND TESTING. OVERALL, IT IS THE COUNTY'S LARGEST HOUSING AND RYAN WHITE CASE MANAGEMENT PROVIDER TO PLWH. THEREFORE, THE AGENCY HAS THE EXPERIENCE, INFRASTRUCTURE, AND CONSTITUENCY, INCLUDING RELATIONSHIPS WITH PRIORITY UNDERSERVED POPULATIONS, TO IMPLEMENT THIS PROGRAM IMMEDIATELY AND EFFECTIVELY, COMPLEMENTING EXISTING SERVICES AND ADDING A NEW DIMENSION TO CARE.